Effect of clinical pharmaceutical care on our outpatient service of Traditional Chinese Medicine pharmacy / 药学实践杂志

Objective To explore the role of clinical pharmaceutical care in outpatient service of traditional Chinese medicine. Methods Two hundred patients who were not taking medicines for the first time (had received routine medication explanations) and had made an appointment for the next outpatient TCM service were randomly selected for questionnaire survey during July to October, 2021. After the intervention of clinical pharmacy care, the questionnaire survey was conducted again, and the results of the questionnaire survey of patients before and after the clinical pharmacy care were compared. Results After clinical pharmacy intervention, the scores of eight questions in the questionnaire were significantly improved (except for the awareness of taking drugs, P values of the other seven items were all <0.05). Conclusion The development of TCM clinical pharmaceutical care could effectively improve patients' safety awareness of medication safety. The patients' awareness of the use of Traditional Chinese Medicine and medication compliance had also been significantly improved. The awareness of pharmacists role in patients was enhanced. The outpatient pharmaceutical care of Traditional Chinese Medicine was effectively improved, which is important to rational drug use.

Exploration of reform paths of high-level talents training in clinical pharmacy / 中国药房

OBJECTIVE To help to realize high-quality development of clinical pharmacy education in China by exploring new reform paths of high-level talents training in clinical pharmacy. METHODS The concept definition and key links of high-level talents training in clinical pharmacy were consulted by expert consultation， and the literature analysis and empirical methods were used to prepare a questionnaire to conduct online research on clinical pharmacy professionals in universities and hospitals. RESULTS A total of 637 effective electronic questionnaires were received. Totally 95.13% of the respondents believed that the cultivation of high-level talents in clinical pharmacy was very or relatively important； 51.96% expressed different degrees of dissatisfaction with the current situation of training； 88.85% regarded “rational clinical use of drugs” and 88.70% regarded “clinical research of drugs” as one of the main training objectives and service orientation； precision pharmacy， evidence-based pharmacy， medication therapy management， therapeutic drug monitoring and evaluation， clinical discovery and evaluation of new drugs were considered as important core specialty knowledge and competences， which were different from those high-level talents in clinical medicine；62.01% agreed that “academic degree+professional degree” dual degree training was the main degree type for high-level talents training in clinical pharmacy； 79.28% thought it was very necessary or relatively necessary to adopt the “long schooling” education mode； 98.58% thought that the core courses of clinical pharmacy such as clinical pharmacotherapy were very important or relatively important；59.81% believed that college or department of clinical pharmacy was the most important educational management organization that played the most important role； 87.13% agreed with the dual tutor structure of “college teachers+ pharmacists” and “pharmacists+physicians”. CONCLUSIONS Starting with the target orientation， core knowledge and competence， academic degree system， curriculum system and faculties， it is necessary to speed up the exploration of new reform paths of talent training and build a high-level talent training system of clinical pharmacy with Chinese characteristics and world level.

Análise das intervenções farmacêuticas clínicas em Unidade de Terapia Intensiva de um hospital de urgência e trauma / Analysis of clinical pharmaceutical interventions in the Intensive Care Unit of an emergency and trauma hospital

Analisar o perfil das intervenções farmacêuticas providas pelos farmacêuticos clínicos por meio da análise de prescrições médicas em uma Unidade de Terapia Intensiva (UTI) adulto generalista. Metodologia: Trata-se de um estudo transversal, prospectivo e observacional, com abordagem quantitativa, realizado na UTI de um hospital público referência em urgência e trauma do estado de Goiás. Os dados foram coletados no período de junho a agosto do ano de 2022, por meio da análise diária das prescrições. Resultados: A população estudada compreendeu 74 pacientes, em sua maioria do sexo masculino (68,92%), hipertensos (27,03%), e diabéticos (14,86%). Foram analisadas 568 prescrições, e identificados 489 problemas relacionados a medicamentos, sendo os mais prevalentes: medicamento inapropriado/desnecessário ou contraindicado (30,67%) e necessidade de medicamento adicional (24,34%). As classes de medicamentos mais envolvidas nos problemas foram: anti-infecciosos gerais para uso sistêmico (23,72%), e agentes do sistema nervoso (23,11%). Das intervenções farmacêuticas promovidas, 84,25% foram aceitas, com maior frequência: suspender medicamento (30,67%) e iniciar terapia medicamentosa (23,72%). Conclusão: Diante dos resultados apresentados, nota-se a boa taxa de aceitabilidade das intervenções, destacando a importância da atuação do farmacêutico clínico dentro da UTI na prevenção de problemas relacionados à farmacoterapia, bem como na melhoria dos desfechos terapêuticos

To analyze the profile of pharmaceutical interventions provided by clinical pharmacists through the analysis of medical prescriptions in a generalist adult Intensive Care Unit (ICU). Methodology: This is a cross-sectional, prospective and observational study, with a quantitative approach, conducted in the ICU of a public hospital that is a reference in emergency and trauma in the state of Goiás. Data were collected from June to August of 2022, through the daily analysis of prescriptions. Results: The population being studied comprised 74 patients, mostly male (68.92%), hypertensive (27.03%), and diabetic (14.86%). 568 prescriptions were analyzed, and 489 problems related to medication were identified, the most prevalent being: inappropriate/unnecessary or contraindicated medication (30.67%) and need for additional medication (24.34%). The drug classes most involved in the problems were: general anti-infectives for systemic use (23.72%) and nervous system agents (23.11%). Of the promoted pharmaceutical interventions, 84.25% were accepted, most frequently: discontinuing medication (30.67%) and starting medication therapy (23.72%). Conclusion: In view of the results presented, there is a good rate of acceptability of the interventions, highlighting the importance of the role of the clinical pharmacist within the ICU in preventing problems related to pharmacotherapy, as well as in improving therapeutic outcomes

Cuidado clínico farmacêutico e estratégia para o uso racional e adesão ao tratamento em pacientes com hanseníase numa Policlínica do Recife / Pharmaceutical clinical care and strategy to rational use and adhesion to treatment in Hansen's disease patients at a policlinic from Recife

Introdução: a hanseníase é uma doença de fácil diagnóstico, possuindo tratamento e cura. Quando diagnosticada tardiamente, pode trazer graves consequências para os portadores e seus familiares. Uma vez que o tratamento da hanseníase está inserido no componente estratégico da assistência farmacêutica, são exigidos cuidados e orientação. Há necessidade de intervenção clínica farmacêutica, com objetivo de acompanhar prescrições medicamentosas, analisando a adesão dos pacientes ao tratamento com a promoção de ações de educação em saúde, além de minimizar a ocorrência de eventos adversos relacionados aos fármacos do tratamento com possível redução de custos associados aos agravos. Objetivo: realizar o monitoramento para identificar e tratar as possíveis intercorrências que estão comumente presentes no tratamento de hanseníase. Metodologia: a realização do estudo deu-se com o acompanhamento dos pacientes atendidos no serviço de referência a partir da aplicação de questionários em consultas periódic as, vis to que a adesão ao tratamento, reduç ão dos eventos adver sos e controle dos comunic antes são de suma impor tância para o controle epidemiológico. Resultados: os principais sintomas dos indivíduos acometidos foram dormência e eritema nodoso hansênico. A maioria utilizava como tratamento o esquema multibacilar e talidomida. O acometimento relatado dos pacientes foi em nível moderado. Os pacientes possuíam comorbidades como hipertensão, artrose e diabetes. O acompanhamento clínico foi relatado como positivo pela maioria dos entrevistados. Conclusão: o desfecho do estudo mostra que a adesão do paciente é crucial para o êxito do tratamento e o acompanhamento do farmacêutico clínico constitui um pilar positivo, contribuindo para a prevenção de agravos e conscientização da comunidade.

Introduction: Hansen's disease is an easily diagnosed disease, with treatment and cure available. When diagnosed late, it can bring serious consequences for patients and their families. Since the treatment of Hansen's disease is part of the strategic component of pharmaceutical assistance, care and guidance are required. There is a need for clinical pharmaceutical intervention, aiming to monitor drug prescriptions, analyze patients' adherence to treatment while promoting health education actions, in addition to minimizing the occurrence of adverse events related to treatment drugs with possible reduction in costs associated to grievances. Objective:thus, the present study aimed to monitor, identify, and treat possible complications commonly present in the treatment of Hansen's disease. Methodology: The study was carried out with the follow-up of patients seen at the reference service, through the application of questionnaires in periodic appointments, since adherence to treatment, reduction of adverse events and control of communicants are of short importance for epidemiological control. Results:The main symptoms of Hansen's disease patients were numbness and leprosy nodosum erythema. Most used the multibacillary scheme and thalidomide as treatment. The reported involvement of patients was at a moderate level. Patients had other comorbidities such as hypertension, arthrosis and diabetes. The clinical assistance was reported as positive by most interviewees. Conclusion: The outcome of the study shows that patient's compliance is crucial for the success of treatment and the clinical pharmacist's accompaniment is a positive pillar, contributing to the prevention of complications and community awareness.

Análise de intervenções farmacêuticas utilizando um instrumento de acompanhamento farmacêutico em uma Unidade de Terapia Intensiva Pediátrica / Analysis of pharmaceutical interventions using a pharmaceutical monitoring instrument in a Pediatric Intensive Care Unit

Introdução: A pediatria apresenta um cenário bastante específico devido ao uso de medicamentos off-label e carência de estudos científicos direcionados à utilização de medicamentos por essa população. Assim, o farmacêutico clínico pode contribuir na identificação e prevenção de problemas relacionados a medicamentos.Métodos: Estudo de coorte retrospectivo realizado em uma unidade de terapia intensiva pediátrica de um hospital universitário do Rio Grande do Sul. Foram analisadas as intervenções farmacêuticas realizadas entre março de 2016 a julho de 2018 por farmacêuticos clínicos. Tais intervenções foram reclassificadas conforme os critérios de um instrumento de acompanhamento farmacêutico (bundle) utilizado na rotina. Foi realizada análise estatística descritiva das variáveis estudadas.Resultados: Das 582 intervenções farmacêuticas analisadas, as categorias mais prevalentes foram dose (n = 97; 16,7%), necessidade (n = 92; 15,8%) e forma farmacêutica (n = 56; 9,6%). Após reclassificação das intervenções farmacêuticas utilizando o bundle, os critérios mais prevalentes foram: critério 1 (revisão da farmacoterapia; n = 285; 49%), critério 4 (analgesia; n = 78; 13,4%) e critério 10 (antimicrobianos; n = 65; 11,2%). As classes de medicamentos mais frequentes foram os do sistema nervoso (n = 213; 36,6%) e os anti-infecciosos gerais para uso sistêmico (n = 115; 19,8%). A taxa de adesão das intervenções farmacêuticas pela equipe médica foi de 85,1%.Conclusão: A classificação das intervenções farmacêuticas utilizando o bundle pode contribuir no aperfeiçoamento do instrumento tornando-o mais viável para uso na unidade de terapia intensiva pediátrica e direcionar o trabalho do farmacêutico clínico nas situações que geram mais problemas relacionados a medicamentos.

Introduction: Pharmaceutical interventions in the pediatric setting are highly peculiar due to the use of off-label drugs associated with the lack of scientific studies on the use of drug therapies in this population. Thus, clinical pharmacists may help identify and prevent drug-related problems.Methods: We conducted a retrospective cohort study in the pediatric intensive care unit of a teaching hospital in Rio Grande do Sul, Brazil. Pharmaceutical interventions conducted between March 2016 and July 2018 were analyzed by clinical pharmacists. These interventions were reclassified according to the criteria of a routine pharmaceutical monitoring instrument (care bundle). We conducted a descriptive statistical analysis of study variables.Results: Of 582 pharmaceutical interventions analyzed, the most prevalent categories were dose adjustment (n = 97; 16.7%), need for drug therapy (n = 92; 15.8%), and dosage forms (n = 56; 9.6%). After reclassification of pharmaceutical interventions, the most prevalent criteria were criterion 1 (review of drug therapy; n = 285; 49%), criterion 4 (analgesia; n = 78; 13.4%), and criterion 10 (antimicrobials; n = 65; 11.2%). The most common drug classes were nervous system agents (n = 213; 36.6%) and anti-infectives for systemic use (n = 115; 19.8%). The rate of adherence to pharmaceutical interventions by the medical team was 85.1%.Conclusions: The classification of pharmaceutical interventions according to the pharmaceutical care bundle may help improve the instrument, allowing its use in the pediatric intensive care unit and guiding clinical pharmacists in situations causing drug-related problems.

Prevalence of vitamin D deficiency in medical students

Aging seldom comes alone and it is considered to be the major factor for many diseases and comorbidities and disabilities. The objectives of the study are to examine demographic characteristics and prevalence of comorbidities and polypharmacy of elderly patients who were admitted at Sebha Medical Center according to the selected period. This study is descriptive and retrospective cross-sectional study conducted in Sebha during 2021. From 195 participants of the study, the highest rate of patients was from the age group of 65 - 74 years which accounted for 86 participants (44%) and followed by those age group of 75 - 84 years which was reported by 65 participants (33%). The majority of elderly patients have hypertension, (n = 116, 59%) and over one-third of the patients (n = 73, 37%) have diabetes mellitus while nearly one-quarter of patients have both diseases at the same time (n = 47, 24%). Nearly, three-quarters of patients have electrolytes imbalance (n = 142,72%). Nearly, two-thirds of the patients had three to five comorbidity diseases (n = 122, 63%). Whereas, over one-third of the patients had just one or two comorbidities (n = 70, 36%). Almost all the participants have polypharmacy (n = 187, 96%). Just above half of the patients have five - ten medications (n = 100, 51%) compared with 45% of the patients from those who have more than ten medications (n = 87). This study showed that there is a strong relationship between the prevalence of polypharmacy and the number of comorbidities. A Spearman correlation test indicated that rate of comorbidities was related to polypharmacy with a significant correlation (P < 0.01). The present study found high prevalence of comorbidities and polypharmacy among elderly inpatients. Based on this high prevalence, practicing pharmaceutical care could play an effective role to reduce the risk of inappropriate polypharmacy among hospitalized elderly patients through encouraging clinical pharmacist to engage in clinical activities in hospitals

Bioética clínica e ensino-aprendizagem de estudantes de Farmácia: propostas do modelo deliberativo de Diego Gracia / Clinical bioethics and teaching-learning of Pharmacy students: proposals from Diego Gracia's deliberative model / Bioética clínica y enseñanza-aprendizaje de estudiantes de Farmacia: propuestas desde el modelo deliberativo de Diego Gracia

Resumo: de maneira geral, a atenção em saúde engloba atividades que demandam dos profissionais farmacêuticos a atuação clínica segura. Essa atuação considera a relação aperfeiçoada com os pacientes por meio de atributos para lidar com cenários conflitantes, os chamados "problemas ético-morais". Nesse sentido, o método deliberativo de Diego Gracia atua na discussão democrática prudente de casos com base em fatos, valores e deveres, formando comitês multiprofissionais. O estudo em questão apresenta contribuições da aplicação do método deliberativo em sala de aula, com a abordagem de problemas relevantes para a atividade farmacêutica e humana sob o olhar da Bioética contemporânea trabalhado em conjunto com discentes do curso de Farmácia dos 6° e 10° períodos, respectivamente. A deliberação como estratégia de ensino possibilitou a reflexão dos alunos quanto às inúmeras perspectivas na tomada de decisão em saúde, considerando aspectos como cultura, religião e sociedade; além disso, exaltou a importância das disciplinas concernentes à Deontologia e à Bioética na matriz curricular.

Summary: In general, health care encompasses activities that demand safe clinical performance from pharmaceutical professionals. This performance considers the improved relationship with patients through attributes to deal with conflicting scenarios, the so-called "ethical-moral problems". In this sense, Diego Gracia's deliberative method operates in the prudent democratic discussion of cases based on facts, values and duties, forming multidisciplinary committees. The study in question presents contributions from the application of the deliberative method in the classroom, with the approach of relevant problems for the pharmaceutical and human activity under the gaze of contemporary Bioethics worked together with students of the Pharmacy course of the 6th and 10th periods, respectively. Deliberation as a teaching strategy made it possible for students to reflect on the numerous perspectives in health decision-making, considering aspects such as culture, religion, and society; in addition, he highlighted the importance of subjects related to Deontology and Bioethics in the curriculum.

Resumen: en general, el cuidado de la salud engloba actividades que exigen un desempeño clínico seguro por parte de los profesionales farmacéuticos. Esta acción considera la mejora de la relación con los pacientes a través de atributos para enfrentar escenarios conflictivos, los denominados "problemas ético-morales". En este sentido, el método deliberativo de Diego Gracia opera en la prudente discusión democrática de los casos a partir de hechos, valores y deberes, formando comités multi- disciplinarios. El estudio en cuestión presenta aportes desde la aplicación del método deliberativo en el aula, con el abordaje de problemas relevantes para la actividad farmacéutica y humana bajo la mirada de la Bioética contemporánea trabajada junto a estudiantes de la carrera de Farmacia de los períodos 6° y 10°, respectivamente. La deliberación como estrategia de enseñanza posibilitó que los estudiantes reflexionaran sobre las múltiples perspectivas en la toma de decisiones en salud, considerando aspectos como la cultura, la religión y la sociedad; además, resaltó la importancia de las materias relacionadas con la Deontología y la Bioética en el plan de estudios.

Discussion and analysis on the necessity of setting up the training system of stomatological clinical pharmacist / 中华医学教育探索杂志

At present, there is still no stomatology specialty in the training system of clinical pharmacists in China and the relevant research is still blank. The development of stomatological clinical pharmacy is also slow due to the lack of clinical pharmacists. By analyzing the national oral health policies, the characteristics of oral diseases and the clinical needs of stomatology, this paper provides theoretical basis for the setting of clinical pharmacist training specialty of stomatology specialty in China. This paper also makes a preliminary discussion on the construction of the training system of clinical pharmacists in the specialty of stomatology, so as to provide advice and references for the design and specific plan of the training system in the specialty of stomatology.

Construction and practice of undergraduate training mode for clinical pharmacy specialty based on outcome-based education / 中国药房

OBJECTIVE To introduce the construction of undergraduate specialty of clinical pharmacy based on the concept of outcome-based education （OBE），and to provide new idea and enlightenment for the construction of undergraduate specialty of clinical pharmacy in Chinese universities. METHODS Through the establishment and construction of training objectives and graduation requirements ，teaching reform was designed and implemented ，and the construction of teaching support system and teaching quality assurance system were completed. RESULTS The clinical pharmacy department of our university established the training direction of clinical pharmacy talents under the guidance of post competence ，including clarifying the training needs of undergraduate talents based on the overall requirements of national undergraduate education ；defining the social and industrial needs of clinical pharmacy talents based on the normative documents or concepts of clinical pharmacy ；clarifying the post and ability needs of clinical pharmacy talents based on the investigation of graduates and clinical pharmacists ；clarifying the development needs of clinical pharmacy based on the current situation and trends at home and abroad ；forming characteristic training objectives combined with the regional characteristics and school positioning ， so as to construct training objectives and graduation requirements. The OBE concept was introduced into the undergraduate teaching reform of clinical pharmacy ；the pharmacy talent training direction were established under the guidance of post competence ；the training system was designed by reverse design method；a training mode of both innovation and practical ability was built so as to promote teaching reform ，strengthen the construction of grass-roots teaching organizations and teaching staff ， and improve the construction of teaching quality assurance system. CONCLUSIONS The undergraduate training mode of clinical pharmacy specialty based on the concept of OBE is helpful to improve students ’personal comprehensive quality and professional knowledge and skills. The established undergraduate training model of clinical pharmacy specialty is in line with the modern educational concept and social needs ，and provides theoretical basis and practical experience for the training mode of clinical pharmacy professionals.

The pharmaceutical care bundle: development and evaluation of an instrument for inpatient monitoring

Introduction: Care bundles help healthcare professionals provide the best care possible in a structured and reliable way. The purpose of this study was to develop and apply an instrument for inpatient follow-up by clinical pharmacists, and evaluate its results. Methods: The care bundle was based on previously validated instruments. Population consisted of patients monitored by clinical pharmacists at a general hospital. The study was conducted in two phases: the first involved the development and implementation of the bundle, and the evaluation of pharmaceutical interventions; the second involved analyzing data from patients treated with the bundle over one year. Results: The bundle included fourteen pharmaceutical follow-up criteria used in different patterns by each area of care. In the first phase of the study, 3263 patients were monitored and 536 pharmaceutical interventions were performed, with an 85.3% compliance rate. In the second phase of the study, follow-up data was collected from 21,214 patients. The bundle criteria were used in a similar way in clinical, surgical and cancer patients. Pharmacotherapy review was the most prevalent intervention in all cases (60.1%). Hospital discharge planning and medication reconciliation were performed with a similar frequency in clinical, surgical, pediatric and general patients. Conclusions: The development and validation of a bundle aimed at guiding the clinical activities of pharmacists helped standardize procedures and interventions. Pharmacotherapy review was the bundle criterion with the highest rate of application and interventions due to the hospital's complexity and the need to consider individual patient needs and follow institutional policies. (AU)

A importância da farmácia clínica no contexto hospitalar / The importance of clinical pharmacy in the hospital context / La importancia de la farmacia clínica en el contexto hospitalario

Objetivo: Descrever a importância e a contribuição da farmácia clínica na promoção em saúde dentro de uma organização hospitalar, destacando os consensos sobre esta temática na literatura científica especializada. Método: revisão narrativa realizada por meio de busca online na Biblioteca Virtual de Saúde, com os seguintes descritores: Farmácia clínica; Hospital; Farmacêutico. Delimitou-se o período de 2010 a 2020, ou seja, nos últimos 10 anos, e artigos disponibilizados na íntegra. Os dados de cada estudo foram extraídos, sendo elaborado um quadro com as principais variáveis para analisar o perfil dos artigos coletados. Resultados: Após o cruzamento dos descritores, foi possível encontrar uma amostra de 64 artigos inicialmente. Adotando o critério de inclusão relacionado à necessidade de os artigos serem publicados no idioma português, dos últimos 10 anos e disponibilizados em sua íntegra, observou-se que, deste total, 31 atendiam a estes critérios. Por fim, a amostra final foi composta por 12 artigos. O farmacêutico clínico hospitalar tem diferentes responsabilidades, contribuindo para a promoção à saúde através da aquisição, provisão e controle de insumos essenciais ao paciente internado; tem função indispensável na prevenção de reações adversas e dos riscos das interações medicamentosas; garante a segurança do paciente por meio do uso racional dos medicamentos prescritos pelos médicos; e tem uma participação ativa na adesão ao tratamento e prevenção de agravos em geral. Considerações finais: a farmácia clínica hospitalar apresenta importância para a saúde pública de uma forma geral e o farmacêutico clínico torna-se uma peça chave dentro da equipe multiprofissional hospitalar

Objective: To describe the importance and contribution of clinical pharmacy in health promotion within a hospital organization, highlighting the consensus on this topic in the specialized scientific literature. Method: narrative review carried out through an online search in the Virtual Health Library, with the following descriptors: Clinical pharmacy; Hospital; Pharmaceutical. The period from 2010 to 2020 was delimited, that is, in the last 10 years, and articles made available in full. The data for each study were extracted, and a table was created with the main variables to analyze the profile of the collected articles. Results: After crossing the descriptors, it was possible to find a sample of 64 articles initially. Adopting the inclusion criterion related to the need for articles to be published in the Portuguese language, from the last 10 years and made available in its entirety, it was observed that, of this total, 31 met these criteria. Finally, the final sample consisted of 12 articles. The hospital clinical pharmacist has different responsibilities, contributing to health promotion through the acquisition, provision and control of essential supplies to inpatients; it plays an indispensable role in preventing adverse reactions and the risks of drug interactions; guarantees patient safety through the rational use of medicines prescribed by doctors; and has an active participation in adherence to treatment and prevention of diseases in general. Final considerations: the hospital clinical pharmacy is important for public health in general and the clinical pharmacist becomes a key part of the hospital multiprofessional team

Objetivo: Describir la importancia y contribución de la farmacia clínica en la promoción de la salud dentro de una organización hospitalaria, destacando el consenso sobre este tema en la literatura científica especializada. Método: revisión narrativa realizada mediante búsqueda online en la Biblioteca Virtual en Salud, con los siguientes descriptores: Farmacia clínica; Hospital; Farmacéutico. Se definió el período de 2010 a 2020, es decir, en los últimos 10 años, y se pusieron a disposición los artículos en su totalidad. Se extrajeron los datos de cada estudio y se elaboró una tabla con las principales variables para analizar el perfil de los artículos recolectados. Resultados: Luego de cruzar los descriptores, fue posible encontrar inicialmente una muestra de 64 artículos. Adoptando el criterio de inclusión relacionado con la necesidad de que los artículos se publiquen en lengua portuguesa, de los últimos 10 años y estén disponibles en su totalidad, se observó que, de este total, 31 cumplían con estos criterios. Finalmente, la muestra final estuvo conformada por 12 artículos. El farmacéutico clínico hospitalario tiene diferentes responsabilidades, contribuyendo a la promoción de la salud a través de la adquisición, provisión y control de insumos esenciales para pacientes hospitalizados; juega un papel indispensable en la prevención de reacciones adversas y los riesgos de interacciones medicamentosas; garantiza la seguridad del paciente mediante el uso racional de los medicamentos recetados por los médicos; y tiene una participación activa en la adherencia al tratamiento y prevención de enfermedades en general. Consideraciones finales: la farmacia clínica hospitalaria es importante para la salud pública en general y el farmacéutico clínico se convierte en una pieza clave del equipo hospitalario multiprofesional.

Atuação do farmacêutico clínico na unidade de terapia intensiva / Clinical pharmacist's performance in the intensive care unit / Papel del farmacéutico clínico en la unidad de cuidados intensivos

Dentro do ambiente hospitalar, a Unidade de Terapia intensiva é a responsável pelo cuidado do paciente crítico. Esse cuidado é realizador por uma equipe multidisciplinar, que trabalha em conjunto para garantir a integralidade do cuidado ao paciente. O Farmacêutico Clínico, dentro dessa equipe, garante a economia e o uso racional dos medicamentos, sem perda da qualidade e eficácia do tratamento. Esse artigo tem como objetivo analisar os benefícios da atuação do farmacêutico dentro da equipe multiprofissional na Unidade de Terapia Intensiva. Para isso, foi realizada uma revisão integrativa de literatura, utilizando descritores de Assistência Farmacêutica, Farmácia Clínica e atuação do Farmacêutico em Unidades de Terapia Intensiva. Dentro dos resultados obtidos destaca-se, em todos os artigos, a importância do Farmacêutico no cuidado ao paciente crítico, a importância e necessidade desse profissional e as melhorias obtidas em hospitais que implantaram o serviço de Cuidado Farmacêutico. A intervenção desse profissional gera melhoria na qualidade de vida do paciente, promove redução de custos, aumenta a eficácia, a segurança e o uso racional de medicamentos

Within the hospital environment, the Intensive Care Unit is responsible for the care of critically ill patients. This care is a director by a multidisciplinary team, which works together to ensure the integrality of patient care. The Clinical Pharmacist, within this team, guarantees the economy and rational use of medicines, without loss of quality and efficacy of treatment. This article aims to analyze the benefits of the pharmacist's performance within the multidisciplinary team in the Intensive Care Unit. For this, an integrative literature review was carried out, using descriptors of Pharmaceutical Care, Clinical Pharmacy and the pharmacist's performance in Intensive Care Units. Within the results obtained, the importance of the Pharmacist in the care of critical lye, the importance and need of this professional and the improvements obtained in hospitals that implemented the Pharmaceutical Care service stand out in all articles. The intervention of this professional generates improvement in the quality of life of the patient, promotes cost reduction, increases efficacy, safety and rational use of medications.

Dentro del ámbito hospitalario, la Unidad de Cuidados Intensivos se encarga de la atención de los pacientes críticos. Esta atención es dirigida por un equipo multidisciplinario, que trabaja en conjunto para garantizar la integralidad de la atención al paciente. El Farmacéutico Clínico, dentro de este equipo, garantiza la economía y el uso racional de los medicamentos, sin pérdida de calidad y eficacia del tratamiento. Este artículo tiene como objetivo analizar los beneficios del desempeño del farmacéutico dentro del equipo multidisciplinar en la Unidad de Cuidados Intensivos. Para ello, se realizó una revisión integradora de la literatura, utilizando descriptores de Atención Farmacéutica, Farmacia Clínica y el desempeño del farmacéutico en Unidades de Cuidados Intensivos. Dentro de los resultados obtenidos, destacan en todos los artículos la importancia del Farmacéutico en el cuidado de la lejía crítica, la importancia y necesidad de este profesional y las mejoras obtenidas en los hospitales que implantaron el servicio de Atención Farmacéutica. La intervención de este profesional genera mejora en la calidad de vida del paciente, promueve la reducción de costes, aumenta la eficacia, la seguridad y el uso racional de los medicamentos

Acompanhamento clínico farmacêutico no cuidado ao paciente adulto-cirúrgico em um hospital universitário de Porto Alegre / Clinical pharmacist follow-up in adult surgical patient care in a university hospital of Porto Alegre

Introdução: O farmacêutico clínico já está bem estabelecido em algumas instituições e muitos serviços de saúde contam com este profissional em suas equipes, entretanto, poucos conseguem sistematizar o seu trabalho e mapear os dados das atividades desenvolvidas, demonstrando a relevância do profissional na equipe de saúde. O objetivo deste trabalho foi avaliar o acompanhamento clínico-farmacêutico em uma unidade de internação adulto-cirúrgica em um hospital universitário de Porto Alegre. Métodos: Estudo descritivo retrospectivo que quantificou as principais atividades do farmacêutico clínico em uma unidade de internação adulto-cirúrgica no período de janeiro a maio de 2019. Este projeto foi aprovado no Comitê de Ética em Pesquisa da referida instituição. Resultados: 859 pacientes foram admitidos na unidade cirúrgica avaliada, dos quais 490 foram revisados pelo farmacêutico na admissão hospitalar, correspondendo à taxa média de 57,27%. A taxa média de conciliação medicamentosa realizada foi de 14,83%, totalizando 73 pacientes conciliados por entrevista. 361 intervenções farmacêuticas foram realizadas no período estudado, sendo 54 relacionadas a conciliação medicamentosa, com o número total de adesões de 232. As principais especialidades cirúrgicas que internam pacientes na unidade em questão foram a Ortopedia, Cirurgia do Aparelho Digestivo, Urologia e Cirurgia Vascular. Conclusões: Foi possível avaliar o acompanhamento clínico farmacêutico em uma unidade de internação adulto-cirúrgica em um hospital universitário de Porto Alegre, através da quantificação das taxas de pacientes revisados e de conciliação medicamentosa, do número de intervenções farmacêuticas e suas adesões, além de caracterizar as principais especialidades médicas cirúrgicas envolvidas. (AU)

Introduction: Clinical pharmacists are already well established in some institutions, and many health services have these professionals in their teams. However, few are able to systematize their work and map data from the developed activities, demonstrating the relevance of these professionals in the health team. This study aimed to evaluate the clinical pharmacist follow-up in an adult surgical inpatient unit in a university hospital in Porto Alegre. Methods: This is a retrospective, descriptive study that quantified the main activities of the clinical pharmacist in an adult surgical inpatient unit from January to May 2019. This project was approved by the Research Ethics Committee of the institution. Results: Of 859 patients admitted to the s rgical unit, 490 were reviewed by the pharmacist on hospital admission, corresponding to an average rate of 57.27%. The average medication reconciliation rate was 14.83%, totaling 73 patients reconciled per interview. Of 361 pharmaceutical interventions performed during the study period, 54 were related to medication reconciliation, and the total number of adhesions was 232. The main surgical specialties associated with admission to the study unit were Orthopedics, Digestive System Surgery, Urology, and Vascular Surgery. Conclusions: It was possible to evaluate the clinical pharmacist follow-up in an adult surgical inpatient unit in a university hospital in Porto Alegre by quantifying the rates of reviewed patients and medication reconciliations as well as the number of pharmaceutical interventions and their adherences, in addition to characterizing the main medical-surgical specialties involved. (AU)

Comparison of Chinese and American clinical pharmacy education and reflections / 中华医学教育探索杂志

Clinical pharmacy is an important part of hospital pharmacy. Education of clinical pharmacy is one of the most important tasks in clinical pharmacy personnel training. At present, there is a considerable progress in the development of clinical pharmacy education in China, however, the professional quality of clinical pharmacists is still insufficient and there is a gap between the disciplinary education and clinical practice. In this article, we discuss the origin, development, academic degree, curriculum, teaching methods and practice certification of clinical pharmacy education in China and in United States, in order to explore the applicable methods of clinical pharmacy education in China. It will provide ideas and references for the optimization of the training of clinical pharmacy professionals, accelerating the development of clinical pharmacy in China.

Application of Team Situational Simulation Education and Teaching Mode in Clinical Pharmacy Teaching / 中国药房

OBJECTIVE：To explore th e applicatio n of team situatio nal simulation education and teaching mode in clinical pharmacy teaching. METHODS ：A total of 60 clinical pharmacy interns were selected as the research objects ，and course disease was type 2 diabetes mellitus. Thirty interns were randomly selected as control group ，using traditional teaching mode ；other 30 interns were selected as trial group ，which carried out team situational simulation education and teaching mode. The teaching effects were evaluated by using the satisfaction of interns to the two modes ，the comprehensive score of graduation examination and the self-evaluation of learning effect. RESULTS ：Compared with traditional teaching mode ，team situational simulation education and teaching mode was conducive to stimulate the learning interest of interns ，improve their interpersonal communication ability ， cultivate teamwork spirit ，improve the awareness of humanistic care ，and cultivate the professional attitude of clinical pharmacists （P＜0.05）. Compared with control group ，the comprehensive score of trial group was dominantly increased （P＜0.001），and the scores of professional quality ，humanistic care and communication skills in the trial group were significantly higher than control group（P＜0.01）. In terms of self-evaluation of learning effect ，except for the pathogenesis of type 2 diabetes and the commonly used treatment regimens ，the self-evaluation scores of the other items in trial group were significantly higher than control group （P＜0.05 or P＜0.01）. CONCLUSIONS ：Team situational simulation education and teaching mode is superior to traditional teaching mode for clinical pharmacy teaching.

Mass Gathering (Hajj) Clinical Pharmacy Services: New Initiative in Saudi Arabia

Objective: To declare the clinical pharmacy services during the mass gathering hajj period as a new initiative in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national mass gathering pharmaceutical programs. The projects drove the mass gathering medicine guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The mass gathering clinical pharmacy services with a defined vision, mission and goals. The services had multiple benefits, including clinical and economical on the healthcare system, as described in the review. The continuation of the services assured by risk management elements description. Moreover, the monitoring and controlling of the projects as illustrated. The transition to operation project, though closing project stage illustrated in the analysis. Conclusion: The clinical pharmacy services during the mass gathering hajj period is a new initiative project in the mass gathering medicine. Multiple clinical pharmacy services can be started during a mass gathering with an emphasison decrease morbidity and mortality; it is highly recommended in the Kingdom of Saudi Arabia.

Profile of activities developed by community pharmacists: do they corroborate the precepts of the pharmaceutical profession?

Studies that addressed the profile of pharmaceutical activities and behaviors in community pharmacies in the last decades pointed to a gap between community pharmacy practice and the precepts of the profession. Facing the need to analyze whether the new legislation has impacted this scenario, the objective of this study was to describe the general profile and academic profile of community pharmacists, and the profile of the activities they develop, as well as to know their place of work. This is a descriptive study, to which all pharmacists in charge of community pharmacies in the metropolitan area of ​​Belo Horizonte-MG (n = 1624) were invited. Data collection was performed through a questionnaire validated online, from October to December 2017, via Google Docs®. Responses were obtained from 109 pharmacists, most of them female, aged 31-40 years, being general graduates, and in private institutions. Pharmacotherapeutic follow-up, an activity linked to clinical management, is performed by only 37.60% of pharmacists, evidencing that there is still a lag in relation to the provision of clinical services by community pharmacists. Thus, we emphasize the importance of implementing the precepts established by Brazilian curricular guidelines for undergraduate pharmacy courses which focus on the development of clinical skills, since the insertion of the pharmacist into the health team and the provision of clinical services to the community can add new value to the use of medications, and contribute effectively to their rational use in Brazil.

Investigation and Study on Present Situation of Clinical Pharmaceutical Care in 39 Medical Institutions in Chong- qing / 中国药房

ABSTRACT OBJECTIVE：To investigate the present situation of clinical pharmacy in different levels of medical institutions in Chongqing，and to investigate the method for optimizing clinical pharmaceutical care. METHODS：By questionnaire survey，50 sample medical institutions（including 15 third level hospitals，25 second level hospitals and 10 first level hospitals）in Chongqing were selected according to the region，the level of medical institutions，comprehensive and specialized hospitals. The team of clinical pharmacists and the development of clinical pharmacy were investigated，and the results were statistically analyzed to find common problems and put forward relevant suggestions. RESULTS & CONCLUSIONS：Totally 45 questionnaires were collected， with a recovery rate of 90％，of which 39 questionnaires were qualified，with a qualified rate of 86.67％. There were 32 hospitals （82.05％）in 39 medical institutions with clinical pharmacy departments and 4 hospitals（10.26％）with clinical pharmacist training base. There were 239 full-time pharmacists in 39 medical institutions，with an average of 6.13 persons in each medical institution， including 4.5 full-time clinical pharmacists，and 2-5 full-time clinical pharmacists（25 hospitals）in most medical institutions. Top 5 clinical departments that clinical pharmacists mainly participated in were respiratory department，cardiovascular department， endocrinology department，ICU and oncology department. Most of the clinical pharmacists（16 hospitals，42.11％）worked in the clinic for more than 50％ to no more than 80％. The number of medical institutions（28-37，＞70.00％）carrying out ADR monitoring， rational drug use knowledge publicity， prescription and medical order comment， ward round， consultation， editing and publishing drug information was relatively high. 28 medical institutions（78.95％）did not carry out the test of therapeutic drugs；39（100％）medical institutions had carried out the education of patients’drug use，in the form of billboards（30 hospitals，78.95％），science lectures（28 hospitals，73.68％）and drug education forms（28 hospitals，73.68％）The contents of drug use education mainly included precautions（39 hospitals，100％），usage and dosage（37 hospitals，97.37％）， ADR（36 hospitals，94.74％）. 29 hospitals had carried out clinical pharmaceutical research（73.68％），mainly rational drug use research（28 hospitals，73.68％）；5 medical institutions（12.82％）had set up joint pharmacy outpatient service，2（5.12％）had set up independent pharmacy outpatient service，the rest had not set up pharmacy outpatient service（26 hospitals，66.67％）. In this survey，it is found that there are some problems，such as incomplete coverage of beds in the ward in pharmaceutical care，weak foundation of scientific research in pharmaceutical departments. It is suggested that the national and local health committees should strengthen the construction of multi-level clinical pharmacy talent echelon，explore and train resident clinical pharmacists，select and build key clinical pharmacy specialties in Chongqing，and establish incentive mechanism for clinical pharmacists. Medical institutions at all levels can adopt multiple ways to accelerate the training of clinical pharmacists，increase the publicity of pharmacists’outpatient service，change the working mode of the ward，cultivate special clinical pharmacists，improve the ways and paths of continuing education，and enhance the strength of scientific research to improve the level of clinical pharmaceutical care.

Forecasting (2018-2030) and the Demand of Clinical Pharmacy Technician Workforce at Over Twelve Years (2006-2017) in Saudi Arabia

Background: The workforce of clinical pharmacy technician is one the elements of pharmacy strategic plan in Saudi Arabia. Objectives: The purpose of this study is to explore the demand clinical pharmacy technician’s workforce at Ministry of Health (MOH) hospitals and primary health care centers over the past twelve years (2006- 2017) and forecasting during the years (2018-2030) in the kingdom of Saudi Arabia. Methods: It is a retrospective analysis of twelve years (2006-2017) of MOH hospitals, Primary Health Care Center (PHCs) of the pharmacy technician’s workforce and forecasting for future years (2018-2030). All data were derived from the Ministry of Health statistical year books and any missing appropriate information about pharmacy technician’s workforce that will be estimated through allied healthcare professional’s data in each region including gender. It included all types of pharmacy technicians included in the study while excluded all pharmacists or clinical pharmacist’s workforce at MOH intuitions. All calculations were based on MOH workforce standards of hospitals or PHCs updated literatures. All calculation was done using Microsoft Excel version ten. Results: The total average of hospitals was 253.92 in the kingdom of Saudi Arabia. The total average demand of clinical pharmacy technician at MOH hospitals will be (4,579.08) over twelve years (2006-2017) with a range (2,899 to 6,619). The total average demand of clinical pharmacy technician at primary healthcare centers will be (1,303) over twelve years (2006-2017) with a range (891 to 1,623). The total average demand of clinical pharmacy technician at hospital forecasting will be (10,271.34) over thirteen years (2008-2030) with a range (8,797.44 to 11,887.11). The total average demand of clinical pharmacy technician at primary healthcare centers forecasting will be (14,270.87) over thirteen years (2018-2030) with a range (12,223.05 to 16,515.79). Conclusion: The Ministry of Health hospitals and primary care centers sectors will be with the highest demand for clinical pharmacy technician in the future. The ratio of pharmacist to clinical pharmacy technician needs to be standardized at hospitals and primary healthcare services. Further, the analysis of the clinical pharmacy technician workforce is required in the kingdom of Saudi Arabia.

Knowledge and attitude of health care professional’s towards clinical pharmacy services in Nedjo General Hospital, Western Ethiopia

Background:Clinical pharmacy service(CPS) is an expanding patient-oriented, hospital role with the potential for encroachment on the physician's role. In large part, the success of CPS will depend on the degree to which other health professionals accept the concept and are willing to cooperate with its disciples. Unfortunately, our information about the degree of knowledge regardingacceptance and reaction toward clinical pharmacy by other health workers is meager. Methods:A cross sectional study design was carried outby using self–administered questionnaires on 110 health care professionals (HCP)in Nedjo General Hospital 10th March to 10th April, 2018..Results:From the total respondents 91 (82.7%) were malesand majority of them were nurses 46(41.8%) followed by midwifes 23(20.9%). This study showed that 67(60.9%) of the HCPs hada good knowledge and 67.3% of the HCPs hada positive attitude about CPS. There was no significant difference between the HCPs knowledge of clinical pharmacy services in relation to their sex (p=0.744), age (p=0.313), profession (p=0.997), level of education (p=0.509), and experience (p=0.553).Regarding HCPs’ attitude of CPs role, there was no significant difference in relation to their sex (p=0.588), age (p=0.144), profession (p=0.059) and experience (p=0.394). However, the study revealed that there was a significant difference (p=0.009) between HCPs attitude and level education of HCPs.Conclusions:Majority of the HCPs hada good knowledge and a positive attitude towards CPS. Attention should focus to hospitals to implement ward based CPS and increasing inter-professional relationships between HCPs and pharmacists.